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General NPI Number Information
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NPI Number | 1609320464
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Entity Type | Organization
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Legal Business Name | DR. PEPERMINTWALA PLLC
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 4214 ANDREWS HWY STE 108
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City | MIDLAND
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State | TX
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Zip | 79703-4813
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Country | US
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Telephone | 432-218-9920
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Fax | 432-218-9356
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Provider Business Mailing Address
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Address Line | 4214 ANDREWS HWY STE 108
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City | MIDLAND
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State | TX
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Zip | 79703-4813
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Country | US
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Telephone | 432-218-9920
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Fax | 432-218-9356
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAMSUDDIN PEPERMINTWALA
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Credential | M.D.
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Telephone | 432-218-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | K4525
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License Number State | TX
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